# US 7,744,611 B2 · Minimally invasive valve repair procedure and apparatus > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 7,744,611 B2 - Document ID: US7744611B2 - Status: Granted - Kind: B2 - Application number: 10/718,236 - Filed: 2003-11-19 - Published: 2004-06-10 - Granted: 2010-06-29 - Earliest claimed: 2000-10-10 - Assignees: Medtronic, Inc. - Inventors: John D. Nguyen; Laurent Schaller; Arthur Hill - Web page: https://patentgrep.com/patent/US7744611B2 ## CPC - A61B 17/064: Surgical staples, {i.e. penetrating the tissue} - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 17/06: Needles {; Sutures; Needle-suture combinations}; Holders or packages for needles or suture materials - A61B 2017/0472: {Multiple-needled, e.g. double-needled, instruments} - A61B 2017/06009: {having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle} - A61B 2017/06057: {Double-armed sutures, i.e. sutures having a needle attached to each end} - A61B 2017/081: {Tissue approximator (A61B2017/1103, A61B17/8866 take precedence)} - A61F 2/2442: {Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract A clip of a self-closing type is used for valve repair. The clip is generally U-shaped with two end points separated from each other when it is constrained to be in an open configuration, but tends to coil up to assume its natural closed configuration if the constraint is removed. At least one end point is connected through a suture to a tissue-penetrating needle. A needle holder has an outer tube and an inner member which has a slit at the front and is slidable inside the outer tube. They are designed such that the slit can grab the needle tightly or release it as the inner member is moved backward or forward with respect to the outer tube. With the needle secured at the front, the needle holder is passed through a cannula inserted through an incision and the needle penetrates the leaflets such that the clip can be positioned with its end points hooked to the pair of leaflets to be stitched together. If the clip is released from the suture thereafter, it tends to coil up, reducing the distance between the end points and pulling the leaflets together. A double-arm clip assembly with each of the end points of the clip attached through a suture to a separate needle may be similarly used for valve repair. Such a double-arm clip assembly may contain two of such clips mutually connected by means of a flexible connector such that two leaflets are held together by the connector, with the two clips each anchored to a corresponding one of the leaflets. ## Claims ### Claim 1 A clip assembly comprising: two clips each having two end points, a proximal end point and a distal end point, the proximal end point and the distal end point being separated from each other when said clip is held in an open configuration and tending to return to a naturally closed configuration wherein the distance between said proximal end point and said distal end point is reduced; two tissue penetrating needles each releasably connected to one of said two end points of a corresponding one of said two clips through a flexible member; and a flexible connector connecting the other end points of said two clips together. ### Claim 2 (depends on 1) The clip assembly of claim 1 wherein said clips comprise a wire made of a shape memory material. ### Claim 3 (depends on 1) The clip assembly of claim 1 further comprising releasing means for normally keeping the two clips in the open configuration and releasing each of the two clips to become separated from the associated flexible member to thereby allow the clips to begin returning to the closed configuration. ### Claim 4 (depends on 1) The clip assembly of claim 1 wherein each of said clips further comprise a stopper connected to one of said two end points of said clip. ### Claim 5 (depends on 1) The clip assembly of claim 1 wherein the flexible connector comprises a suture. ### Claim 6 (depends on 1) The clip assembly of claim 1 wherein the flexible connector comprises a metal wire. ### Claim 7 A clip assembly comprising: two clips each having two end points which are separated from each other when said clips are in an open configuration and tending to return to a naturally closed configuration by reducing distance between said end points when the clip is in said open configuration; two tissue penetrating needles each connected to one of said two end points of a corresponding one of said two clips through a flexible member; and a flexible connector connecting the other end points of said two clips together; and releasing means for normally keeping said two clips in said open configuration and releasing each of said two clips to become separated from the associated flexible member to thereby allow said clips to begin returning to said closed configuration. ### Claim 8 (depends on 7) The clip assembly of claim 7 wherein the clips comprise a wire made of a shape memory material. ### Claim 9 (depends on 7) The clip assembly of claim 7 wherein each of said clips further comprise a stopper connected to one of said two end points of said clip. ### Claim 10 (depends on 7) The clip assembly of claim 7 wherein the flexible connector comprises a suture. ### Claim 11 (depends on 7) The clip assembly of claim 7 wherein the flexible connector comprises a metal wire. ### Claim 12 A minimally invasive method of holding two tissue parts together, said method comprising the steps of: providing a clip assembly which comprises two clips each having two end points which are separated from each other when said clips are in an open configuration and tending to return to a naturally closed configuration by reducing distance between said end points when the clip is in said open configuration, two tissue penetrating needles each releasably connected to one of said two end points of a corresponding one of said two clips through a flexible member, and a flexible connector connecting the other end points of said two clips together; penetrating and completely pulling one of the needles through a tissue part and penetrating and completely pulling the other of the needles through an adjacent tissue part while said clips are each in said open configuration; pulling the needles until each of said clips is hooked to a corresponding one of the tissue parts; and allowing said clips to start to return to said naturally closed configuration, whereby said two tissue parts are held together by said flexible connector stretched between said clips. ### Claim 13 (depends on 12) The method of claim 12 wherein said clips comprise a wire made of a shape memory material. ### Claim 14 (depends on 12) The method of claim 12 wherein said flexible connector forms a loop when stretched between said clips. ### Claim 15 A minimally invasive method of holding two tissue parts together, said method comprising the steps of: providing a clip assembly which comprises two clips each having two end points which are separated from each other when said clips are in an open configuration and tending to return to a naturally closed configuration by reducing distance between said end points when the clip is in said open configuration, two tissue penetrating needles each connected to one of said two end points of a corresponding one of said two clips through a flexible member, and a flexible connector connecting the other end points of said two clips together; penetrating and completely pulling one of the needles through a tissue part and penetrating and completely pulling the other of the needles through an adjacent tissue part while said clips are each in said open configuration; pulling the needles until each of said clips is hooked to a corresponding one of the tissue parts; and allowing said clips to start to return to said naturally closed configuration, whereby said two tissue parts are held together by said flexible connector stretched between said clips; wherein said clip assembly further comprises releasing means for normally keeping said two clips in said open configuration and releasing each of said two clips to become separated from the associated flexible member to thereby allow said clips to begin returning to said closed configuration, and wherein said clips are allowed to start to return to said naturally closing configuration by separating said clips from said needles through said releasing means. ### Claim 16 (depends on 15) The method of claim 15 wherein said clips comprise a wire made of a shape memory material. ### Claim 17 (depends on 15) The method of claim 15 wherein said flexible connector forms a loop when stretched between said clips.